Senate Republicans Vote Against Physicians and the Elderly

It has become common place to note that a tremendous number of people vote against their economic interest by voting Republican. This is generally applied to working class voters who vote Republican. I hope that after today’s Senate vote more of my colleagues in the medical profession will finally realize that they have also been voting against our economic interests by generally voting Republican.

Several years ago a very faulty formula was devised to determine physician reimbursement under Medicare. The formula was written so as to pay physicians less if health care expenses rise. The fault in the formula is that health care expenses have been rising every year for reasons beyond the control of individual physicians, making this formula useless as a tool to motivate physicians to keep health care costs down. Every year for the past several years we have gone through a series of threats of large cuts in reimbursement, and at the last minute Congress has stepped in and overruled the automatic formula.

Last December Congress postponed a 10.6% cut for the first six months of the year under the assumption that they would come up with a longer term fix. The plan supported by many in Congress, at least among the Democrats, was to take the money from excess payments paid to Medicare Advantage plans. The plans are  George Bush’s reward to the insurance industry for all the huge contributions they have made to him and other Republicans. Contrary to the usual conservative claim that private business can do anything government can do for less money, Medicare Advantage plans were set up to pay private insurances about 13% more than it costs to care for patients under the government Medicare program.

The House overwhelmingly voted for a plan end this corporate welfare program and instead use the money  to avoid the 10.6% cut to physicians, along with some other improvements in Medicare. The measure failed by one vote in the Senate. (Harry Reid later voted no as a procedural matter so it could be brought up again.) The vote was along party lines with the vast majority of Senate Republicans voting against the measure. George Bush, another Republican, also threatened to veto the measure.

Just in case anyone missed this, I will repeat: The Republicans in the Senate, along with Republican President George Bush, are the ones who backed a physician pay cut of 10.6%. I wonder if my colleagues will learn a lesson from this.

Actually we are already seeing signs that they are. The first sign of pressure on a Republican Senator has been seen in Texas. The Texas Medical Association Political Action Committee has withdrawn their endorsement for Republican Senator John Cornyn, who helped defeat the measure.

Of course the Democrats are not motivated purely out of a desire to help physicians. They also realize that elderly patients on Medicare will have quite a hard time finding physicians who will accept them as patients if this is not reversed. The American Medical Association, AARP, and numerous health care organizations supported the failed measure, and some Republican Senators might wind up paying a political price for deciding to stand with George Bush. In a statement protesting the failure of Congress to resolve this matter, James King, President of the American Academy of Family Physicians wrote:

Family physicians have worked tirelessly on behalf of Medicare patients. Despite those efforts, family physicians have struggled with 20 percent inflation in costs for office space, equipment, supplies, health and administrative staff, medical liability insurance and other costs of business since 2001. During that time, their Medicare compensation for their services has stagnated. No small business – as most family physician practices are – can sustain that kind of loss and remain open to care for people.

The impact of this failure goes beyond the medical community; it threatens Medicare beneficiaries’ access to health care because it further drives family physicians toward financial insolvency. Access problems for these patients are emerging. In its 2007 presentation to Congress, MedPAC reported that 30 percent of Medicare beneficiaries were having trouble finding a new primary care physician. In March, the Medical Group Management Association reported that nearly 24 percent of physicians in all specialties had begun limiting or not accepting new Medicare patients; 46 percent would limit or stop accepting new Medicare patients with implementation of the 10.6 percent pay cut scheduled for July 1.

There is hope that the matter will be resolved when Congress returns from their recess.  It is only necessary for a singe Republican Senator to be convinced by their constituents to change their mind. Another factor is that Ted Kennedy, who undoubtedly would have voted yes, was not present for health reasons.

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3 Comments

  1. 1
    phil hargus says:

    It is sad, but the bright side is the upcomming election,
    of course the eldery will have the final vote on this issue.-

  2. 2
    Lybba says:

    » Senate Republicans Vote Against Physicians and the Elderly … http://bit.ly/cebo0u

  3. 3
    Kirk says:

    RT @lybba: » Senate Republicans Vote Against Physicians and the Elderly … http://bit.ly/cebo0u <—HUH?

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